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Oral Phase Mgmt/Tx

Oral Phase Compensatory Strategies

Downward Pressure on Tongue (w/spoon) To treat reduced oral sensation, delayed oral/pharyngeal swallow. Improves oral sensory awareness.
Sour & Cold Bolus To treat reduced oral sensation, delayed onset of swallow, pharyngeal delay. Improves oral sensory awareness. Put in mesh cloth if swallowing not wanted.
Thermal Tactile Swallow Treats delayed initiation of pharyngeal aspect of swallowing. Improves oral sensory awareness. Stroke anterior faucial pillars w cold stimulus. Effect continues for several swallows after. Not permanent.
Bolus requiring chewing & Large Volume & Suck-Swallow treats reduced oral sensation, delayed oral/pharyngeal swallow. Improves oral sensory awareness.
Tactile + Proprioceptive Input from bolus requiring chewing
Increased tongue elevation from Suck-Swallow
Other compensatory strategies multiple swallows, small sips/amounts, modifying food presentation
Liquid Wash immediately following pudding/solid if its getting stuck (oral/pharyngeal residue)
3 second prep from neurological/psychological research, preparing to swallow mentally
External support external pressure to weaker cheek, labial & chin support
Intraoral prosthetics For tongue resection, palatal work, lower palatal work, helps swallow
Most Invasive Strategy Changing food consistency
Thickened Liquids Treats oral tongue dysfunction, delayed pharyngeal swallow
Purees Treats delayed pharyngeal swallow, reduced laryngeal closure
Rehabilitative Strategies for Oral Phase Stretch Reflex, OM exercises, resistance, bolus propulsion, ROM exercises (passive & active), lifting back of tongue,
Stretch Reflex- rehab strategy for oral weakness
OM exercises- rehab strategy for Oral weakness, drecreased ROM, therapist initiated (passive) lip stretches, patient initiated (active)=pucker/release,close lips smack hard, smack,retract/hold,puff cheeks,resist ext. pressure
Resistance- rehab strategy for oral weakness/decreased ROM. Push against tongue depressor.
Bolus Manipulation- rehab strategy for decreased ROM. therapist holds bolus in mesh on string and pt moves it around
Bolus Propulsion- rehab strategy for decreased ROM. Juice in gauze, pt squeezes juice out and swallows
ROM exercise- rehab strategy for decreased ROM. Elevate anterior/posterior tongue and hold. side to side. pull tongue back/hold.
Lift back of tongue- rehab strategy for decreased lingua velar seal, not base of tongue. Hard /k/ words
protocol recommendations- how many trials a day? 25
protocol recommendations- how many days a wk? 6
protocol recommendations- how many wks? 8
Created by: kaskas